원저 : Helicobacter pylori 감염 유무와 정도 반영에 대한 C-14와 C-13 요소호기검사 정량치 비교 (Comparison of the Quantitative Values of C-14 and C-13 UBT to Reflect the Presence and Degree of Ongoing Helicobacter pylori Infection) |
Author |
임석태, 김동욱, 정환정, 손명희, |
Seok Tae Lim, M.D., Dong Wook Kim, Ph.D., Hwan-Jeong Jeong, M.D. and Myung-Hee Sohn, M.D. |
Affiliation |
전북대학교 의학전문대학원 핵의학교실, 의과학연구소, 임상의학연구소 Department of Nuclear Medicine, Institute for Medical Sciences, and Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea |
Abstract |
Purpose: A urea breath test (UBT) using C-14 or C-13 has been developed for identifying Helicobacter (H) pylori infection on the basis of urease production with release of labeled CO2. We investigated if the C-14 and C-13 UBT have the difference to reflect the presence and degree of H. pylori infection detected by gastroduodenoscopic biopsies (GBx) in the same patients.
Materials and methods: Thirty eight patients (M:F=28:10, age 53.4±13.0 yrs) with upper gastrointestinal symptoms such as indigestion, gastric fullness or pain consecutively underwent C-14 UBT, GBx and C-13 UBT within one week before medications. For the C-14 UBT, a single breath sample was collected at 10 minutes after ingestion of C-14 urea (37 KBq) capsule and counting was done in a liquid scintillation counter for 1 minute, and the results were classified as positive (≥200 dpm), intermediate (50~199 dpm) or negative (<50 dpm). For the C-13 UBT, the results were classified as positive (≥2.5‰) or negative (<2.5‰). The results of GBx with Giemsa stain were graded 0 (normal) to 4 (diffuse) according to the distribution of H. pylori by the Wyatt method. We compared C-14 UBT and C-13 UBT results with GBx grade as a gold standard.
Results: The prevalence of H. pylori infection by GBx with Giemsa stain was 25/38 (65.8%). In the assessment of the presence of H. pylori infection, the C-14 UBT global performance yielded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 92.0%, 92.3%, 95.8%, 91.7% and 92.1%, respectively. However, the C-13 UBT had sensitivity, specificity, PPV, NPV and accuracy of 96.0%, 84.6%, 92.3%, 91.7% and 92.1%, respectively. The more significant correlation in C-14 than C-13 UBT (r=0.948 vs r=0.819, p<0.001) was found between the value of UBT and the grade of distribution of H. pylori infection.
Conclusion: We conclude that the diagnostic performance between C-14 and C-13 UBT to detect H. pylori infection is not significantly different, but the value of C-14 UBT more significantly reflects the degree of bacterial distribution. |
Keyword |
urea breath test, C-14, C-13, Helicobacter pylori |
Full text Article |
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